Uterine Fibroids and PCOS: Symptoms, Causes, and Treatments

Polycystic ovary syndrome (PCOS) isn’t the only condition that affects women’s reproductive health. There are several others with overlapping symptoms, which can make it tricky to tell them apart. That’s why getting an accurate diagnosis is so important—it’s the first step toward finding the right treatment (and finally getting relief!).

One condition that’s often mistaken for PCOS is uterine fibroids. They share a lot of similar symptoms and both affect the uterus, hormones, and overall reproductive health. To help you sort it all out, here’s a simple guide to the key similarities and differences between PCOS and fibroids.

Here’s what you need to know:

Uterine Fibroids and PCOS: Symptoms, Causes, and Treatments

In this post, I’ll break down the symptoms, causes, and risk factors of both polycystic ovarian syndrome (PCOS) and uterine fibroids. Understanding the differences between the two will help you feel more confident talking to your doctor about what’s really happening. 

By the end, you’ll have a clearer picture of each condition and some guidance on how to take back control of your health. 

Are Fibroids and PCOS the Same Thing?

No, PCOS and uterine fibroids are not the same thing. PCOS is a hormonal condition that impacts the whole body, including the ovaries. Women with PCOS may experience ovarian cysts, which are painful, fluid-filled sacs that can grow due to hormone imbalances. 

This can be confused with uterine fibroids, which are noncancerous growths in the uterus. Uterine fibroids aren’t in the ovaries, but rather in the muscle tissue of the uterine wall. That said, both ovarian cysts and fibroids can cause pelvic pain, bloating, irregular periods, and pain during sex, which is why they’re often mixed up. However, uterine fibroids affect only the muscle tissues as a localized physical condition whereas PCOS’s hormonal imbalances affect multiple systems of the body.

Side note: Endometriosis also shares several symptoms with uterine fibroids and PCOS. It’s worth learning more about this condition as well. Read my post on endometriosis vs. PCOS for a clear comparison and to see how each condition presents differently.

What Is the Difference Between Uterine Fibroids and PCOS?

Definition: Fibroids vs. PCOS

Uterine fibroids are easy to define: noncancerous growths in the uterus. PCOS is a bit more complex. It’s a hormonal and metabolic condition that can cause a wide range of symptoms, driven by chronic inflammation, insulin resistance, and the hormonal imbalances characteristic of PCOS.

Where They Occur

One common symptom of PCOS is the presence of polycystic ovaries. These cysts form on the ovaries when androgen levels are high and the menstrual cycle is disrupted. Uterine fibroids, on the other hand, are in the uterus itself in various levels of tissue. 

They can be submucosal (under the inner lining), intramural (within the muscular wall), or subserosal (on the outer surface). The main point is that ovarian cysts and uterine fibroids occur in separate locations and affect different parts of the reproductive system. 

Causes and Risk Factors

Both PCOS and uterine fibroids primarily affect women of reproductive age. The risk of either condition is higher if a woman has a family history or higher body fat. However, hormonal imbalances seem to be at play, too. 

High levels of estrogen and progesterone seem to be risk factors for uterine fibroids. In contrast, high estrogen, low progesterone, high androgens, and high insulin come with PCOS. In both conditions, the exact cause isn’t known, but these things seem to increase your risk of developing uterine fibroids or PCOS. 

Diagnosis Methods

Medical professionals diagnose uterine fibroids through a pelvic exam, ultrasound, MRI, or hysterosonography. PCOS is harder to diagnose, but many Cysters learn they have it through a combination of a blood test, ultrasound, and medical history evaluation. Here’s more on how doctors detect PCOS. 

Treatment Options

Both PCOS and uterine fibroids have some kind of hormonal trigger. Because of this, both can be prevented and managed with lifestyle changes like improving your diet, increasing physical activity level, and maintaining a good sleep routine. However, uterine fibroids that have already formed need to be removed through surgery or other medical procedures. Ovarian cysts with PCOS often resolve themselves. 

Common Symptoms

There are several overlapping symptoms of PCOS and uterine fibroids, including:

• Pelvic pain 
• Irregular periods
• Bloating 
• Pain during sex
• Fertility issues 

These are all the symptoms of uterine fibroids, and each one can also be experienced by those with PCOS. That said, PCOS has many additional symptoms, like excessive facial hair, hair thinning, acne, weight gain, fatigue, dark skin patches, mood swings, and digestive problems. So, if you’re experiencing these extra symptoms along with the ones listed above? It’s more likely that you have PCOS rather than uterine fibroids.

Does PCOS Cause Uterine Fibroids?

There’s currently no evidence that suggests PCOS causes uterine fibroids. Some studies show women with PCOS are more likely to develop uterine fibroids, like this Boston University Slone Epidemiology Center study. In contrast, other studies suggest women with PCOS are less likely to have this comorbidity. 

Why the potential increased risk? It’s thought that uterine fibroids form because of imbalances of estrogen and progesterone. Specifically, high estrogen and high progesterone. It’s possible that’s an isolated thing, but common hormonal fluctuations with PCOS could potentially be to blame as well. However, this seems questionable, since women with PCOS often have higher estrogen but low progesterone. This combination typically does not create a hormonal environment that supports fibroid growth.

Can You Have PCOS and Fibroids at the Same Time?

Yes. These are separate conditions that a woman could experience simultaneously. It just depends on hormone levels, family history, and other underlying health conditions. 

If you’re curious, read this one next: Can you have PCOS and endometriosis?

How to Treat Uterine Fibroids With PCOS

• Remove fibroids with minimally invasive procedures or surgery: Uterine fibroids usually have to be removed by a medical professional—they don’t go away on their own. Procedures like uterine fibroid embolization (UFE), myomectomy, or laparoscopy can be helpful for removing fibroids. The rest of these tips help you prevent them! 
• Follow an anti-inflammatory, gluten- and dairy-free diet: A mindful, balanced diet can help balance your hormones and reduce inflammation to reduce the risk of fibroid growth. You can find fibroid- and PCOS-friendly meal plans and recipes on The Cysterhood app! 
• Drink Testosterone Relief Tea: Many herbal teas can actually support hormone balance. Yes, this tea is labeled for testosterone, but research shows it can promote overall hormonal balance to help prevent uterine fibroids and other endocrine issues.
• Engage in regular slow-weighted workouts: Exercise is great for your hormone balance and for lowering body weight, which is a big risk factor for both PCOS and uterine fibroids. Here’s how to work out with PCOS, if you’re looking to get started! 
• Prioritize quality sleep: When you sleep at night, your body carries out vital processes that keep hormones balanced. Focus on improving sleep hygiene to improve your health and reverse PCOS symptoms and uterine fibroids. 
• Take hormone-balancing supplements: Supplements like Ovasitol, Berberine Advanced, and Ovafit’s Metabolism Plus bundle are incredible for hormone balance and overall symptom relief. 
• Remove endocrine disruptors: There are chemicals in products we use every day that can elevate our estrogen levels. Here’s how to remove these endocrine disruptors to reduce your risk of experiencing PCOS symptoms and uterine fibroids. 

Uterine fibroids and PCOS are distinct conditions, but could be linked.

Sometimes, getting an accurate diagnosis can be really challenging. And treating your symptoms can feel impossible if you don’t know what you’re dealing with. I hope this post helps you understand the differences between uterine fibroids and PCOS, allowing you to better navigate what’s happening in your body.

For more information on PCOS and natural symptom management, browse the PCOS Weight Loss blog and listen weekly to A Cyster and Her Mister!